Intimidated by the System: Don’t Be

By Pamela D. Wilson, CSA, MS, BS/BA, CG

A woman called asking for assistance in having her father released from a nursing home. Her father was admitted 45 days prior for rehabilitation after a stroke. It was the opinion of the nursing home that her father needed continuous care and should remain in the nursing home permanently.

The director of the nursing home went to the extent to tell the daughter that they would see that Medicare did not pay for his initial 45 days of care if they took him home “against medical advice”. The nursing home further contacted county adult protective services to “advise” the daughter that they would be “supervising” the care she would provide for her father if she moved him home.

The daughter was intimidated and threatened by the director of the nursing home. During the 45 days her father was in the nursing home, his physical abilities declined because he was limited to use of a wheelchair. His daughter saw the continued decline and remembered the previous abilities of her father. She knew the care she could provide for him in her home and what care she needed to hire. She and her father discussed the matter and agreed upon what was best. They made the decision to move him home to live with her as soon as possible.

We provided caregiving assistance immediately when her father was discharged from the nursing home. His daughter took a drill sergeant stance regarding his care and rehabilitation. He received assistance on the days that the daughter worked including daily exercise both physical and mental, showering and meals. Within 30 days he no longer used a wheelchair and began walking independently without a walker.

If you find yourself in a similar situation, it is important to discuss the realities of the situation with your family member. Many care communities like hospitals and nursing homes are concerned about their liability in allowing individuals to return home when a great deal of care is needed. Many families hear the words “24 hour care” and have no idea what this means.

For some it means having a family member accessible 24 hours a day. For others it truly does mean having family or a paid caregiver providing care 24 hours a day. That being said it does not mean that the 24 hour care will be a permanent situation unless memory loss or physical abilities are significant.

When in doubt contact a care advocate who is able to offer advice and recommendations about care needs, options and costs. Health care providers offer support and recommendations. However you and the person for whom you provide care know best the commitment you can make regarding care and rehabilitation. Have confidence in your abilities to make the best decision for you and your family. Agree upon several alternatives and see what works best; always have Plan A and Plan B. By planning ahead and being aware of your options the ability to arrive at the best care situation for you and a loved one are possible.